We all know that music makes us feel better!  It cheers us up, it calms us down, it brings back wonderful memories of love, childhood, holidays, vacations, and our whole lives.  The field of music therapy has provided lots of wonderful information on this and so much more.

The following list is from www.preludemusictherapy.com.  I highly recommend this site to you and encourage you to check out all of the resources it provides!

• Music captivates and maintains attention — it stimulates & utilizes many parts of the brain.
• Music is easily adapted to, and can be reflective of, a person’s abilities.
• Music structures time in a way that we can understand (“that’s the last verse – my exercise session is almost over!”).
• Music provides a meaningful, enjoyable context for repetition.
• Music provides a social context — it sets up a safe, structured setting for verbal and nonverbal communication.
• Music is an effective memory aid.
• Music supports and encourages movement.
• Music taps into memories and emotions.
• Music — and the silences within it — provide nonverbal, immediate feedback.
• Music is success-oriented — people of all ability levels can participate.

If you still have doubts about the power of music in the health and healing world, I urge you to start at the beginning of this blog and read all the way through.  Music is powerful medicine!

Music and medicine are deeply connected. But what kind of music should your surgeon really be listening to?

BY RAHUL PARIKH

iStockphoto/lisagagne/Salon

PopRX is a new weekly column about the intersection of pop culture and medicine.

In 1889 Nietzsche wrote, “Without music life would be a mistake.” As someone who regularly spends a chunk of change on Radiohead and Bright Eyes, I completely agree. I’m not the only doctor who finds nirvana in Nirvana. There’s a reason hospital dramas always feature surgeons listening to — and arguing about — music in the operating room. It’s because music and medicine are deeply connected.

The fascinating links go back as far back as ancient Greece. Apollo, the God of healing, was often depicted with a harplike instrument called a lyre. Some doctors have doubled as musicians. In the 1950s, a group of doctors at the Mayo Clinic started the Notochords (named after the primitive spine in a developing fetus), playing with Duke Ellington and Jack Benny. More recently, NPR ran a story about an orchestra of doctors from Albert Einstein Medical Center in New York.

Surgeons have a particularly profound relationship to music. As Siddhartha Mukherjee noted in his book “The Emperor of All Maladies,” music and medicine “go hand in hand. Both push manual skill to the limit; both mature with practice; both depend on immediacy, precision and opposable thumbs.” A 2008 study, in fact, tested whether musical prowess has any impact on performance during laparoscopic procedures (special scopes that surgeons use to perform minimally invasive procedures). Non-surgeons who had experience playing music performed better at suturing using this equipment than did non-musical participants. There’s perhaps no better example of the facility of the musician-surgeon than Theodor Billroth, a 19th century virtuoso who pioneered surgical techniques to dissect abdominal tumors from the body and whose talent on violin and piano forged a close friendship with Brahms.

But surgeons don’t have to play instruments to enjoy music in the operating room. It’s a regular, enjoyable part of the daily routine and one way a surgeon creates a comfortable atmosphere in a sometimes tense setting. Atul Gawande, contributor to the New Yorker and author of “The Checklist Manifesto,” operates to Modest Mouse, Arcade Fire, the Decemberists and other alternative bands. (He does own a Fender ’62 Stratocaster replica at home, but he says he’s rusty.)

http://www.salon.com/print.html?URL=/mwt/feature/2011/03/07/poprx_music_in_operating_room Page 1 of 2

Salon.com The truth about music in the operating room 3/8/11 11:29 AM

So is operating to music a good idea? Lest you go into a panic the next time you hear Lady Gaga while they’re administering the laughing gas, the answer seems to be yes.

It’s a bit of a tricky thing to prove. It’s far from ethical to take a group of surgeons and measure their performance on and off music while they cut into real patients. But studies have offered some insight into the effects of music on surgical performance. One is from the Journal of the American Medical Association and dates back to the grunge rock era, 1994. In this study, researchers took 50 surgeons and measured blood pressure, heart rate and other physiological markers while they performed a series of subtraction problems. Each volunteer performed this task while listening to self-selected music and, later, music selected by the researchers (“Pachelbel’s Canon in D,” which is supposedly included in a lot of “stress reduction” musical compilations).

It turns out that when surgeons listened to music of their own choosing they had very steady vital signs and performed the subtraction task better than when they listened to Pachelbel. That’s encouraging, though it’s important to note that the surgeons who participated listened to music regularly both in and out of the operating room. So if you’re a surgeon and you think investing in an iPod will make you better with a scalpel and sutures, first ask yourself whether you care for music to begin with.

What about the rest of the operating room team? Anesthesiologists are, of course, indispensable to surgery. Does music help or hurt them? In a study out of the U.K., where 70 percent of anesthesiologists say they’ve been subjected to music in the operating theatre (as the Brits call it), 63 percent of those surveyed said that they enjoyed the sounds of music while they worked. Those in another survey who did not said it was because they felt music reduced their vigilance and impaired communication with other staff members. Not surprisingly, the most distracting tunes were ones they hated the most. On the other hand, another study contradicted any deleterious effect of music on anesthesiologists’ performance: That study measured psychomotor performance, and it didn’t change when subjects were listening to self-chosen music, Pachelbel, white noise or no music at all. Finally, surveys of other O.R. team members (nurses, techs, etc.) indicate that music enhances teamwork and communication among members, though, again, most of those surveyed listened to music regularly on their own time.

The next logical question to ask is: What kind of music should your surgeon be listening to while he or she closes your grapefruit of a hernia or bypasses your clogged coronaries? A study from 1976 suggested that rock (sorry, disco), with its varying rhythm and intensity was best. Other surveys have shown that the preferred genre in the operating room is classical, followed by folk, rock, jazz and blues. But, like the JAMA study I mentioned above, most studies hint that music’s positive effects have more do with the personal preference of the surgeon or the O.R. team than any particular genre of it.

A couple of last points: First, there is a body of evidence that music also helps patients going to surgery, including reducing anxiety before and after an operation; it may help patients cope better with pain, leading to their requiring less pain medicine. Finally, here’s an interesting B-side to this story: Take a listen to a 2001 album called “A Chance to Cut Is a Chance to Cure” by a San Francisco music group named Matmos. The two members of the group, Drew Daniel and Martin Schmidt, took their recording equipment to the hospital and sampled the sounds of surgery, creating electronica out of them. Highlights include “California Rhinoplasty” and “Lasik.” Let the sounds of cauterized flesh and dripping anesthetic be music to your ears.

– Rahul Parikh

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Nearly one-quarter of all Americans avoid dentists because they’re afraid, according to American Dental Association surveys. And the fear comes in many forms.

In an attempt to win back fearful patients, dentists like Dr. Eda Ellis in New York offer spa-like services. WSJ’s health columnist Melinda Beck reports.

There’s fear of pain, fear of needles, fear of drills, fear of blood, fear of gagging, fear of feeling helpless or having personal space violated, fear of being lectured for not brushing or flossing adequately and fear of being admonished for staying away so long.

“I even hate that sucky thing that vacuums up your saliva,” says Carolyn Moody, a Bridgewater, N.J., mother of three who avoided dentists for 10 years. Now she makes sure to bring her iPod. “As soon as I hear that drill, even from another room, my fists clench, my body stiffens and my heart starts pounding,” she adds.

Of course, delaying cleanings and checkups only compounds dental problems. Neglected plaque creates cavities; cavities can lead to root canals; root canals require crowns and eventually implants or dentures or worse, a mouthful of toothless gums. Some oral-health problems also send bacteria into the bloodstream, raising the risk of heart attack, diabetes and dementia.

Now, many dentists are taking pains to win frightened patients back. Some practices let patients virtually sleep through the procedure. Others focus on maximizing soothing distractions while minimizing pain as well as the typical sounds and smells of dentistry that can trigger unpleasant memories.

Dental schools are also paying more attention to communication skills. At New York University College of Dentistry, third-year students practice interviewing patients—played by actors—with a variety of dental problems and phobias.

“You can’t just say, ‘Open up—you have nothing to fear,’ ” says psychologist Hillary Broder, who teaches the course. “You have to establish a rapport and find out what makes them anxious and reassure them that that’s not going to happen.”

“There is usually something that triggers that phobia, like a bad experience when they were a child,” says David Hershkowitz, associate chairman of the school’s department of Cariology and Comprehensive Care. He tells students, “Once you know the trigger point, you can do away with the fear.”

To be sure, not all dentists want to treat anxious patients. “There’s a fair number of dentists who are more phobic of the phobic patients than the phobic patients are of dentistry. They’re difficult to work on and you can’t work at your normal pace says George Kivowitz who has dental practices in New York City and Newtown, Pa. But he finds that kindness and communication can go a long way toward calming patients. “I promise that if I see an area of decay, I don’t have to prove it to you by peeling you off the ceiling.”

Other dentists aren’t eager to work with anxious patients, others have built their practices around treating them. “I have some who go into a full-blown panic attack, shaking uncontrollably, when I merely look in their mouths with a mirror. That’s my flock,” says Manhattan dentist Louis Siegelman.

Feeling Groggy

For some such patients, being asleep or close to it may be the only way to endure dental procedures—even routine cleanings. “You have to meet the patients where they are,” says Dr. Siegelman.

The mildest and most common form of sedation, nitrous oxide—or “laughing gas”—has been used in dentistry since the frontier days and is still considered effective for reducing pain and relieving anxiety. About 35% of dentists offer it. But some patients can’t tolerate wearing a mask over their nose during the dental work, and in rare cases, it can make people more jittery and anxious instead of less.

Oral conscious sedation, in which patients take a tranquillizer such as Halcion or Versed before the visit, puts them into a relaxed and sleepy state although they can still respond to the dentist’s commands. Patients may have little memory of the dental work, but are so groggy they must be accompanied to and from the dentist’s office.

Intravenous sedation gives patients an even greater feeling of being “out,” and can be very useful for extensive gum or implant surgery. It also works quickly and can be increased or counteracted quickly, if necessary. But it does require a needle. The patient’s heart rate, blood pressure and oxygen intake must be monitored in case of cardiac arrest or other problems. And the dentist needs additional training and certification as well as higher malpractice insurance to cover the added risk. General anesthesia, in which the patient is unconscious and unable to respond to commands, is mainly used for oral surgery. That requires even more specialized training.

Costs of sedation, which range from about $50 for nitrous oxide to $350 for IV drugs, are rarely covered by insurance. But some dentists throw it in for free if a patient is having extensive work. Anxious patients often need considerable dental repairs, particularly if they’ve been fugitives from dentistry for years, and many opt to have it all done at once while they are under sedation.

Minimizing Pain

New techniques and tools have made many aspects of dentistry less off-putting than they used to be.

Some dentists and hygienists offer lidocaine spray, gel or patches to numb patients’ teeth and gums even for routine cleanings. Many also wear magnifying loupes that allow them to give patients more personal space. “We can stand about 18 inches away now, rather than six or 12 inches,” says Dr. Hershkowitz.

Electric drills are quieter than older models that were driven by compressed air. In some cases, ultra-quiet lasers can be used instead of drills, but they have many limitations and don’t eliminate the need for anesthesia.

Devices that emit low-dose electrical pulses to block pain pathways right through the skin can be used in place of anesthesia for some procedures.

Unfortunately for the needle phobic, much dental work still requires an injection of local anesthetic—but there, too, there are innovations. For one thing, dental needles used to be sterilized and re-used, getting blunter and more painful to inject each time. Now, needles are used only once.

Numbing gel can also minimize the pain of the stick, but what hurts most about dental injections is the pressure of 1.7 milliliters of fluid pushing into dense tissue. One computerized device called The Wand controls the flow, volume and pressure of the injection and looks more like a pen than a needle. Dr. Kivowitz says that manually delivering an injection very slowly can minimize pain just as well. “Do they ever love it? No,” he says. “But if they understand what you’re doing, it helps a lot.”

He also notes that many anesthetics contain adrenaline, which makes them last longer but can send a patient’s heart racing and trigger panic attacks. It pays to warn patients of the possibility in advance, he says: “Any unexpected thing that happens in the chair just adds to the phobia.”

Maximizing Distractions

Taking a cue from pediatric practices, some dentists offer an array of entertainment options to keep patients’ minds off the drilling and filling, from flat-screen TVs to headphones to virtual-reality goggles for watching 3-D movies.

Some also boast spa-like comforts, such as massaging chairs, warm neck rolls, paraffin wax treatments for hands and reflexology, the traditional Chinese foot massage.

“Mondays and Wednesdays are ‘spa-days.’ We’re very busy then,” says dentist Eda Ellis at Central Park Dental Spa in New York, which also has a waterfall and aromatherapy candles in the waiting room. “Patients love it. THey say, ‘Wait, it’s over so fast?’ ” she says.

What can patients do themselves to alleviate their anxiety? Bring your own distractions—a riveting book, a music player full of transporting tunes or favorite movies if your dentist is equipped to play them.

“Some of my patients have done yoga and they are somewhere else in their minds while I’m working,” says Dr. Hershkowitz who has a private practice in Stony Brook, N.Y.

Behavioral psychotherapists can teach ways to overcome anxiety. Some people find that hypnosis helps them relax, and some hypnotherapists can provide sessions by phone before dental visits.

Don’t try to self-medicate. Drinking alcohol before a dental visit is an especially bad idea. An over-the-counter pain reliever may take the edge off pain, but some forms increase bleeding. Be sure to tell the dentist about any medications you are taking.

Tell the dentist and the staff about your fears. And shop around until you find a practice that is empathetic.

In the meantime, take very good care of your teeth and gums. The healthier they are, the more pleasant every dental visit will be.

—Take a video visit to a New York dental spa, at WSJ.com/Health.

Write to Melinda Beck at HealthJournal@wsj.com

We’ve known for a long time that listening to calm, comforting, soothing music before surgery could do the same thing as the drugs that are now given…and without the risk of adverse reactions or overly and unnecessarily sedating the patient.  Today another study appeared also documenting this! 

Biol Res Nurs. 2011 Jan 28. [Epub ahead of print]

Evidence That Music Listening Reduces Preoperative Patients’ Anxiety.
Lee KC, Chao YH, Yiin JJ, Hsieh HY, Dai WJ, Chao YF.

Abstract
Background: Patients often exhibit preoperative fear and anxiety that may influence the process of induction and recovery from anesthesia. Music is thought to be an alternative to medication for relief of fear and anxiety. Objectives: The purpose of the present study was to explore the feasibility of using heart rate (HR) variability (HRV) for evaluating the efficacy of music listening to relieve the patients’ anxiety during their stay in the operation room waiting area and to compare the HRV measures with subjective Visual Analogue Scale (VAS) scores. Methods: In total, 140 patients were randomly assigned to the experimental (n = 64) or control group (n = 76). The intervention consisted of a 10-min period of exposure to relaxing music delivered through headphones. Anxiety levels were measured by VAS (a 10-point scale) and 5 min of HRV monitoring before and after the music intervention. Results: The music group demonstrated significant reductions in VAS scores, mean HR, low-frequency HRV, and low- to high-frequency ratio and an increase in high-frequency HRV, while patients in the control group showed no changes. The subjective results of patients’ VAS anxiety scores were consistent with the objective results of HRV parameters. Conclusions: Listening to music can significantly lower the anxiety levels of patients before surgery. The frequency-domain parameters of HRV can be indicators for monitoring the change in anxiety level of preoperative patients.

I was thrilled to open my local newspaper this morning (the Louisville Courier-Journal) and find a major news story about how music is being used in Kentucky nursing homes to prompt the staff to re-position patients who are bed-ridden.  Enjoy!

Bedsores can be a serious problem for the elderly, but a University of Cincinnati study aims to curb them at Kentucky nursing homes with the help of music.

Every two hours, music plays over a loudspeaker, prompting caregivers to stop what they’re doing and make sure residents are re-positioned to keep bedsores from forming.

Researchers are partnering with Signature HealthCARE to conduct the study at 10 of the company’s Kentucky homes, including two in Louisville.

“We love it,” said Kelly Thompson, administrator of Signature HealthCARE of East Louisville, which is part of the study group. “They let you pick your music … and everybody knows it’s time for moving.”

“Repositioning people is not something new; what’s new is the prompt,” said Pam Larimore-Skinner, director of nursing at Signature HealthCARE of Trimble County in Bedford, Ky., which also is participating. “I think it makes people more conscious of the two hours because time can get away from you.”

Bedsores, also called pressure sores or pressure ulcers, are damaged areas of skin caused by staying in one position too long. People who are bedridden or use wheelchairs are at greater risk for these sores, which can lead to serious infections that can even be life-threatening. The problem is on the rise nationally.

Medical guidelines say patients should be moved at least every two hours. But nationally, “we know that the compliance of staff is frequently not what we want it to be,” said Elaine Miller, a UC nursing professor.

Researchers from the UC College of Nursing got a two-year, $300,000 grant from the Robert Wood Johnson Foundation to look at whether a simple audio reminder can prompt a nurse-led team to make sure patients move or get moved. The Cincinnati team competed with more than 100 other applicants for the funds.

In the study, four nursing homes used the program since the spring, while another four “comparison” homes were observed for months, then began using the program in November. Two others had problems with intercoms and have been used as comparisons throughout.

“The study involves the ambulatory residents, who can get up themselves, and the bedridden, who need to be turned with the assistance of staff,” said Assistant Professor Tracey Yap, principal investigator on the study. “The musical prompt is a reminder for patients that ‘you need to get up’ and for staff that this is the time to move those who cannot do so themselves.”

Local nursing home officials said their entire staffs are involved in the project, from nurses to administrators to housekeeping workers. Anyone who needs hands-on assistance gets help from the nursing staff, Yap said, while other employees can give verbal reminders to those who don’t need such help.

“It’s a team project,” Yap said. “That’s the innovative part of it.”

Officials said they vary the music so it doesn’t get repetitive or easy to tune out. Larimore-Skinner said her nursing home has played small bursts of everything from classical to country to holiday music.

Thompson and Larimore-Skinner said their facilities are doing well when it comes to pressure sores, and the study program may be one reason. Larimore-Skinner said none of her 49 residents have developed sores in the home, and Thompson said her facility, which has 115 residents, does better than the national average on pressure sores.

Both women said their homes may continue the practice after the study ends in April.

“If it works,” Larimore-Skinner said, “don’t fix what’s not broken.”

By Laura Ungar • lungar@courier-journal.com • December 31, 2010

This is a wonderful video of Deforia Lane practicing her musical magic with a variety of different patients in the hospital in Cleveland!

I can’t say enough good things about Dr. Deforia Lane.  Actually, many people feel the same way and I wanted to share with my readers another wonderful article that was written about her.   I met her early in my journey toward the filed of music medicine.  I consider Deforia to be a dear friends as well as a mentor and she is currently using some of my Surgical Serenity Headphones with patients she works with.  Thank you Deforia!

CLEVELAND, Ohio — Sweet and soothing sounds fill hospital rooms and hallways as Dr. Deforia Lane hits the piano keys to keep up with her tapping toes.

“Patients don’t expect music when they walk into a hospital,” said Lane, Director of Music Therapy at University Hospital’s Case Medical Center.
 
Her angelic voice reaches ears from the cancer wing to the rehab facility, ONN’s Harrison Hove reported.

“Music therapy is a field that is growing enormously,” Lane said.
 
Lane has a gift, whether it’s her welcoming smile, rich voice or the power of her profession.

“Music can draw tears. It can create laughter. People can reminisce. It goes where words cannot,” she said.

It was the music, not words, that led Lane into battle on her own personal journey.

“I was diagnosed with cancer at age 34. I ended up volunteering to bring music to others here and was hired within six months. And that was back in 1983,”  said Lane.
 
Twenty-seven years later, Lane still pushes an aging music cart up and down the hospital halls as part of the music therapy staff.

“There’s everything on that cart from A to Z.  Drums, tambourines, there are tone chimes,” Lane said.

The instruments, the songs and the love and laughter help heal.

“It makes it so much easier to move your hurting parts when you’re doing it to a rhythm rather than jerking through the pain,” said Hinda Apple.

Apple is a  patient at Hanna House and is undergoing three weeks of intense rehab to help regain movements in her arms and legs after a fall.
 
“I used to dance to that,” Apple remembered during one song. A memory from the past brought to the present once again. 

In the Ireland Cancer Center, another brave soul awaits the next round of chemotherapy.

“Pancreatic cancer, bladder cancer,” said patient Daniel Herod. 

Herod and his family are fighting.

“It’d been two months almost. I’ve been going through a terrible sickness,” Herod said. 

But for a few minutes, his own sounds drowned out the beeping machines. The bandages and tubes were forgotten while a family leans on one another and Lane.

“They feel themselves and I can ask for nothing more than that,” said Lane.

“Hallelujah,” exclaimed Herod. “I needed to get that out. That needed to come out.”

Many people sing Lane’s praises.

“Deforia is incredible. She really is,” Apple said.

She continues introducing people to the power of music as medicine.

“It has been the joy of my life,” Lane said.
 
Even though names might eventually be forgotten and faces blur over time, it’s the sounds of Lane’s songs of healing that will stay with these patients forever.

More Information:

Music Therapy At University Hospitals Case Medical Center

Deforia Lane, PHD, MT-BC

Deforia Lane is a dear friend of mine.  I met her when I was on the threshold of stepping into the world of music as medicine back in 1990.  Deforia was just finishing up her Ph.D. in music therapy and was speaking at a conference in Cleveland about her doctoral research on music and the immune system.  After hearing Deforia speak, my decision was made and, thanks to Dr. Arthur Harvey, I  was able to cross over from the world of music performance to music medicine!  Deforia has been a huge influence on me and her ongoing work with music therapy in the hospital setting inpires me to do my work!

It’s easy for others to see why Deforia Lane received the Ohio Hospital Association’s Health Care Worker of the Year award.   Medicine program at University Hospitals in Cleveland, was so surprised by the calling of her name during the awards presentation, that it took several seconds for her to respond to it.

“I went there thinking, ‘This is a free meal tonight.’ That’s all,” Lane laughed during a telephone interview on Tuesday, a handful of hours after the three-hour drive back to Cleveland. The hospital association honored 84 “health-care heroes” on Monday night.

Lane is a certified music therapist. She has bachelor’s, master’s and doctoral degrees in vocal performance and music education. But her most rewarding education has been at the bedside of sick or dying patients at University Hospitals.

There, Lane and her staff of seven music therapists work miracles. They sing, play instruments and compose songs for patients who have lost their voices to illness, tragedy or age.

“We all respond to music,” said Lane, who has witnessed its ability to reduce anxiety, physically relax and create hope for patients. ”Music inspires the soul,” she said.

Lane started the program in 1984 after her second bout with cancer. She attended an American Cancer Society support group at University Hospitals’ Ireland Cancer Center called I Can Cope.

“In short, cancer patients come there to learn what they can about the disease process, the treatment options, etc.,” Lane said. “They are usually six weeks long, about an hour a week, and I was with about seven other patients. We all told our stories and learned a lot.”

Lane was so encouraged “by having been with people who were walking a mile in my shoes” that she asked whether she could compose and sing a song for the last group session.

“I wanted to show my gratitude,” she said.

She received a “yes” from the facilitator, but forgot about her promise until minutes before the final session began. Lane composed her song in the ladies’ room. “I flushed, ran to the group, sang it, we all hugged each other and that was that,” she said.

Soon, Lane was asked to record her song and make a presentation with it at an Ireland Cancer Center employee education seminar. Almost on the spot, she was asked to join the staff — part time — to create University Hospitals’ music therapy program.

Now, 25 years later, Lane looks back at her ongoing journey as a blessing. ”It’s been nothing short of a story made in heaven,” she said.

Mary Vanac is co-founder of MedCity News and serves as its vice president and Ohio bureau chief.